MEDICARE: SABAH MAAODHAH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1356185276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABAH MAAODHAH

Provider Business Mailing Address
First Line	:	1350 7TH ST APT A335
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94607-2153
Country	:	US
Telephone Number	:	510-909-8512
Fax Number	:

Provider Business Practice Location Address
First Line	:	1350 7TH ST APT A335
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94607-2153
Country	:	US
Telephone Number	:	510-909-8512
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	06/24/2024

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Directions to “ SABAH MAAODHAH ” Practice Location

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